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Claude Skills by dromlakhani
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- Ata Ddavp Di ManagementIndividualizes desmopressin (DDAVP) therapeutic schedules for diabetes insipidus, educates patients on overdose risk, and recommends a weekly polyuria phase to assess medication wear‑off. Triggered when initiating DDAVP for diabetes insipidus (e.g., “Use when starting DDAVP for diabetes insipidus…” or “Triggers include: diabetes insipidus requiring desmopressin therapy”).Votes: 0GitHub stars: 12
- Ata Ddavp Postsurgery TrialManages post-pituitary surgery diabetes insipidus (DI) to assess recovery of posterior pituitary function. Triggers include managing DI after pituitary surgery requiring assessment of posterior function via DDAVP discontinuation trial.Votes: 0GitHub stars: 12
- Ata Di Emergency IdRecommends that all diabetes insipidus patients wear an emergency bracelet or necklace to alert clinicians to their condition if incapacitated. Use when establishing care for a diabetes insipidus patient; triggers include diabetes insipidus diagnosis.Votes: 0GitHub stars: 12
- Ata Di WorkupThis skill guides the simultaneous measurement of serum and urine osmolarity to evaluate polyuria for central diabetes insipidus. It is triggered when a patient presents with polyuria exceeding 50 mL/kg/24 hours or 3.5 L/day in a 70‑kg individual.Votes: 0GitHub stars: 12
- Ata Estrogen Lt4 AdjustmentMonitors fT4 levels and adjusts levothyroxine dose to maintain fT4 within the target range when central hypothyroidism patients require changes in estrogen therapy. Triggers include initiating, stopping, or adjusting estrogen therapy (oral or transdermal) in a patient with known central hypothyroidism.Votes: 0GitHub stars: 12
- Ata Gh Athletic Performance AgainstThis skill recommends against using growth hormone (GH) to enhance athletic performance, as the practice is illegal, lacks scientific or ethical justification, and has no substantiated efficacy. It is triggered when a patient requests GH for athletic performance enhancement or when considering GH replacement for athletic performance.Votes: 0GitHub stars: 12
- Ata Gh Biochemical Testing AgainstRecommends against biochemical testing for adult growth hormone deficiency when patients exhibit clear-cut features of GHD alongside three or more documented pituitary hormone deficits. Triggers when evaluating a patient with apparent GHD and multiple hormone deficits such as central hypothyroidism, adrenal insufficiency, and hypogonadism.Votes: 0GitHub stars: 12
- Ata Gh Bmi CutoffUses BMI-specific cutoffs to interpret peak GH values during stimulation testing. Use when interpreting GH stimulation test results; triggers include GH stimulation test requiring BMI-adjusted interpretation.Votes: 0GitHub stars: 12
- Ata Gh Ch MonitoringMonitors euthyroid adults with growth hormone deficiency (GHD) who are initiating GH replacement therapy for the development of central hypothyroidism (CH). Initiates levothyroxine (L-T4) if free thyroxine (fT4) falls below the laboratory reference range; triggers include GHD patient starting GH replacement.Votes: 0GitHub stars: 12
- Ata Gh Dosing AgeCalculates the initial growth hormone (GH) replacement dose based on patient age for adults with proven growth hormone deficiency (GHD). Triggers include initiating GH replacement in patients with proven GHD requiring GH replacement.Votes: 0GitHub stars: 12
- Ata Gh Elderly Low Igf1 AgainstRecommends against administering growth hormone to elderly adults who have age-adjusted low IGF-1 levels and no history of pituitary or hypothalamic disease. Triggered when considering GH replacement in an elderly patient with low IGF-1 (e.g., 'elderly patient with low IGF-1 considering GH replacement').Votes: 0GitHub stars: 12
- Ata Gh Pregnancy DiscontinuationSuggests discontinuing growth hormone (GH) replacement during pregnancy due to lack of clear evidence for efficacy or safety and placental GH production. Triggers include managing a pregnant patient on GH replacement.Votes: 0GitHub stars: 12
- Ata Gh Stim Test IndicationRecommends GH stimulation testing for patients with suspected growth hormone deficiency (GHD). Triggers include evaluating a patient for suspected GHD when single GH measurements are not helpful.Votes: 0GitHub stars: 12
- Ata Gh TitrationTitrates GH replacement dose to keep IGF-1 below the upper limit of normal and reduces dose when side effects appear. Use when monitoring GH replacement therapy; triggers include patient on GH replacement needing dose adjustment.Votes: 0GitHub stars: 12
- Ata Gnrh Testing AgainstRecommends against performing dynamic GnRH stimulation testing in the evaluation of hypogonadism, as it provides no additional diagnostic information beyond baseline gonadotropins and sex steroids. Consider this recommendation when evaluating hypogonadism and contemplating GnRH testing.Votes: 0GitHub stars: 12
- Ata Initial Di Short Acting AdhSuggests initial therapy for diabetes insipidus utilizes short-acting aqueous ADH, allowing safer use in the vast majority of cases where DI resolves spontaneously. Triggers include: new diabetes insipidus diagnosis requiring initial therapy, use when starting diabetes insipidus treatment.Votes: 0GitHub stars: 12
- Ata Lt4 Dosing ChDetermines levothyroxine dosing for central hypothyroidism to achieve serum free T4 in the mid to upper half of the reference range. Triggers include confirmed central hypothyroidism requiring thyroid hormone replacement when initiating L‑4 therapy.Votes: 0GitHub stars: 12
- Ata Mild Ch ManagementManages suspected mild central hypothyroidism in patients with pituitary disease and low-normal free thyroxine (fT4). Initiates levothyroxine (L-T4) when suggestive symptoms are present or when serial fT4 shows a decrease of 20% or more.Votes: 0GitHub stars: 12
- Ata No Prescheduled Ddavp PostopRecommends against prescheduled desmopressin (DDAVP) dosing in the first week after pituitary surgery due to hyponatremia risk from transient diabetes insipidus resolution and syndrome of inappropriate antidiuretic hormone secretion occurring 7–10 days postoperatively. Use when managing a postoperative diabetes insipidus patient in the first week after surgery.Votes: 0GitHub stars: 12
- Ata Oral Estrogen Gh DoseSuggests women on oral estrogen replacement receive higher GH doses compared to eugonadal females or males. Triggers when managing GH replacement in a woman on oral estrogen requiring GH therapy (e.g., "female on oral estrogen needing GH replacement").Votes: 0GitHub stars: 12
- Ata Pituitary Apoplexy Gc Until DiagnosisAdministers glucocorticoid coverage in patients with pituitary apoplexy to prevent adrenal crisis while awaiting definitive laboratory diagnosis. Triggers include managing a pituitary apoplexy patient needing glucocorticoid coverage until laboratory confirmation of pituitary function.Votes: 0GitHub stars: 12
- Ata Pituitary Apoplexy Pituitary Insufficiency TestRecommends testing for acute pituitary insufficiency in all patients with pituitary apoplexy. Use when managing pituitary apoplexy patient; triggers include pituitary apoplexy diagnosis.Votes: 0GitHub stars: 12
- Ata Post Acromegaly Di MonitoringMonitors for diabetes insipidus development after glucocorticoid replacement in cured acromegaly patients; recommends adrenal insufficiency testing if diabetes insipidus improves without an adrenal insufficiency diagnosis. Triggered when managing a cured acromegaly patient receiving glucocorticoid replacement.Votes: 0GitHub stars: 12
- Ata Post Acth Tumor GcRecommend continuing glucocorticoid replacement until hypothalamic-pituitary-adrenal (HPA) axis recovery after surgical resection of ACTH-secreting pituitary tumors. Use when managing postoperative patients following ACTH-secreting tumor surgery to prevent adrenal insufficiency during HPA axis recovery.Votes: 0GitHub stars: 12
- Ata Post Cushing Axis RetestRetest thyroid and GH axes after curative surgery for Cushing's disease before initiating hormone replacement. Use when managing postoperative Cushing's disease patient; triggers include postoperative Cushing's surgery patient needing hormone reassessment.Votes: 0GitHub stars: 12
- Ata Postmenopausal Gonadotrope DiagnosisDiagnoses gonadotrope dysfunction in postmenopausal women by confirming absent high serum FSH and LH when not on hormone replacement therapy. Use when evaluating a postmenopausal woman for hypogonadism; triggers include postmenopausal woman with suspected hypogonadism.Votes: 0GitHub stars: 12
- Ata Postop Pituitary Apoplexy MonitoringRecommends that clinicians monitor pituitary axes in pituitary apoplexy patients treated with surgical decompression or conservative management because hypopituitarism may develop over time. Use when managing pituitary apoplexy patient; triggers include pituitary apoplexy patient needing longitudinal monitoring.Votes: 0GitHub stars: 12
- Ata Postop Pituitary Axis SurveillanceRecommends retesting all pituitary axes starting at 6 weeks after pituitary surgery and periodically to monitor development or resolution of pituitary deficiencies. Use when managing postoperative pituitary surgery patient; triggers include postoperative pituitary surgery patient needing longitudinal hormone monitoring.Votes: 0GitHub stars: 12
- Ata Postop Thyroid Function CheckMeasures free T4 6–8 weeks after pituitary surgery in patients with intact preoperative thyroid function to detect central hypothyroidism. Triggers include postoperative patient needing thyroid function assessment and postoperative patient with intact preoperative thyroid function.Votes: 0GitHub stars: 12
- Ata Preop Ch Lt4This skill guides perioperative levothyroxine management for adults with preoperative central hypothyroidism undergoing non-emergency surgery. Trigger phrases include "preoperative central hypothyroidism patient requiring non-emergency surgery" and "use when managing preoperative CH patient".Votes: 0GitHub stars: 12
- Ata Prolactinoma Axis ReassessRecommends reassessing all pituitary axes in patients with macroprolactinoma and central hypogonadism who have had successful dopamine agonist treatment. Use when managing a macroprolactinoma patient after dopamine agonist treatment with normalized prolactin and tumor shrinkage.Votes: 0GitHub stars: 12
- Ata Tsh Adjustment Ch AgainstRecommends against using serum TSH levels to guide levothyroxine dose adjustments in patients with central hypothyroidism. Triggers include evaluating a central hypothyroidism patient on levothyroxine who requires dose adjustment.Votes: 0GitHub stars: 12
- Endo Add Pegvisomant Cabergoline Inadequate SrlThis skill recommends adding pegvisomant or cabergoline to ongoing somatostatin receptor ligand (SRL) therapy when a patient exhibits an inadequate biochemical response, defined as failure to achieve age‑normalized IGF‑1 or random GH <1 µg/L despite maximally tolerated SRL dose. Consider this step when IGF‑1 remains elevated or GH is not suppressed after an adequate SRL trial, indicating need for combination therapy.Votes: 0GitHub stars: 12
- Endo Annual Gh Igf1 Post Med Withdrawal Rt EfficacyRecommends annual GH and IGF-1 reassessment following medication withdrawal to assess the efficacy of radiation therapy in patients with acromegaly. Use during long-term follow-up after radiotherapy when evaluating biochemical control after a planned drug-free interval.Votes: 0GitHub stars: 12
- Endo Annual Hormonal Testing Post Rt HypopituitarismRecommends annual hormonal testing of patients following radiotherapy to monitor for hypopituitarism and other delayed radiation effects. Use in survivorship care after RT when patients have received pituitary or hypothalamic RT/SRT.Votes: 0GitHub stars: 12
- Endo Avoid Gh Igf1 Monitoring PregnancyThis skill advises against measuring GH or IGF-1 in pregnant patients with acromegaly because placental GH variant interferes with assay interpretation. Use when evaluating hormone testing in a pregnant acromegaly patient.Votes: 0GitHub stars: 12
- Endo Avoid Preop Medical TherapyThe guideline recommends against routine preoperative medical therapy (e.g., somatostatin receptor ligands) solely to improve postoperative biochemical control in acromegaly. Consider this when planning transsphenoidal surgery and evaluating whether to initiate medical pretreatment.Votes: 0GitHub stars: 12
- Endo Avoid Random Gh DiagnosisRecommends against using random GH levels to diagnose acromegaly because of pulsatile secretion. Use when a clinician considers ordering a random GH test to evaluate for acromegaly in a patient with suggestive features.Votes: 0GitHub stars: 12
- Endo Avoid Routine Us Gallstones SrlThis skill advises against routine abdominal ultrasound to screen for gallstone disease in patients receiving somatostatin receptor ligands (SRLs) such as octreotide LAR or lanreotide autogel. Consider this recommendation when planning surveillance imaging for cholelithiasis in asymptomatic SRL-treated acromegaly patients.Votes: 0GitHub stars: 12
- Endo Colonoscopy DiagnosisSuggests screening for colon neoplasia with colonoscopy at the time of acromegaly diagnosis to establish baseline colorectal cancer risk. Trigger when a patient receives a new diagnosis of acromegaly (elevated IGF‑1 with lack of GH suppression after oral glucose tolerance test).Votes: 0GitHub stars: 12
- Endo Confirm Gh Suppression OgttRecommends confirming acromegaly in patients with elevated or equivocal IGF-1 by demonstrating lack of GH suppression to <1 µg/L after an oral glucose load. Triggers include equivocal IGF-1 results requiring diagnostic certainty before proceeding to imaging.Votes: 0GitHub stars: 12
- Endo Discontinue Longacting Srl Pegvisomant PreconceptionThis skill guides discontinuation of long-acting somatostatin receptor ligands (SRLs) and pegvisomant approximately two months before conception attempts in patients with acromegaly, substituting short-acting octreotide as needed for disease control. Trigger phrases include "preconception planning," "patient planning pregnancy," or "about to attempt conception."Votes: 0GitHub stars: 12
- Endo Discontinue Pegvisomant If Lftgt3xConsider discontinuing pegvisomant when alanine aminotransferase (ALT) or aspartate aminotransferase (AST) exceeds three times the upper limit of normal (ULN) during routine monthly liver function testing. This trigger applies to patients receiving pegvisomant for acromegaly who demonstrate transaminase elevations >3× ULN on LFT monitoring.Votes: 0GitHub stars: 12
- Endo Gigantism Standard ApproachesRecommends applying standard acromegaly treatment approaches to normalize GH and IGF-1 in patients with pituitary gigantism. Use when evaluating a child or adolescent with excessive linear growth prior to epiphyseal closure, elevated IGF-1, and nonsuppressed GH after glucose load.Votes: 0GitHub stars: 12
- Endo Hypopituitarism Assess ReplaceRecommends assessing for hypopituitarism and replacing hormone deficits in patients with acromegaly at diagnosis and during follow‑up. Triggered by confirmed elevated IGF‑1, post‑surgical or post‑radiation evaluation, or emergence of symptoms such as fatigue, cold intolerance, or loss of libido.Votes: 0GitHub stars: 12
- Endo Igf1 Atypical With ComorbiditiesThis skill suggests measuring serum IGF-1 in patients who lack typical acromegaly features but present with associated comorbidities such as sleep apnea, type 2 diabetes, debilitating arthritis, carpal tunnel syndrome, hyperhidrosis, or hypertension. It is triggered when a clinician encounters a patient with these conditions without classic signs of acromegaly.Votes: 0GitHub stars: 12
- Endo Igf1 Pituitary Mass RuleoutRecommends measuring serum IGF-1 to exclude acromegaly in any patient discovered to have a pituitary mass on imaging. Triggers include incidental pituitary lesion found on MRI/CT for unrelated reasons.Votes: 0GitHub stars: 12
- Endo Igf1 Typical ManifestationsRecommends measuring serum IGF-1 to screen for acromegaly in patients presenting with typical acral and facial manifestations such as enlarging ring or shoe size, macroglossia, or frontal bossing. Trigger phrases include “acral enlargement,” “facial coarsening,” “prognathism,” or “spade‑like hands” prompting IGF-1 measurement.Votes: 0GitHub stars: 12
- Endo Initial Adjuvant Srl Pegvisomant SignificantThis skill suggests initiating either a somatostatin receptor ligand (SRL) or pegvisomant as adjuvant medical therapy in patients with moderate-to-severe signs and symptoms of GH excess and no local mass effects following transsphenoidal surgery. Clinical triggers include postoperative IGF-1 elevation, persistent acromegalic symptoms, or residual tumor without compressive mass effect.Votes: 0GitHub stars: 12
- Endo Lft Monitoring PegvisomantThis skill outlines monitoring of liver function tests (LFTs) during pegvisomant therapy for acromegaly. It recommends obtaining LFTs monthly for the first 6 months and then every 6 months, with consideration of discontinuing pegvisomant if transaminases exceed three times the upper limit of normal.Votes: 0GitHub stars: 12